Researchers at Wills Eye Hospital offered the hypothesis that selective laser trabeculoplasty (SLT) is a safe and effective first-line treatment for glaucoma but is underutilized for this purpose. Using educational slides that presented the advantages of SLT, they set out to evaluate areas of resistance for increased adoption of first-line SLT.

Fifty-three general ophthalmologists, ophthalmology residents, and glaucoma specialists took part in this study. Before watching the slides, 85% said they do offer SLT to newly diagnosed patients, although only 26% preferred SLT over glaucoma medications (66%) or other treatments (8%).

Though 52% of study participants reported that 10% or less of their newly diagnosed patients choose SLT, 47% said they would use SLT as a first-line therapy for all or most newly diagnosed glaucoma patients, citing good compliance (30%) and efficacy (28%) as the main reasons. They cited patient hesitancy (17%) the most common reason not to choose SLT. More than 90% of study participants said the slide presentation was effective in advocating SLT as a first-line therapy, with safety (53%), efficacy (51%), and adherence (49%) as the main reasons.

The researchers, who presented their findings at the recent ARVO meeting, concluded that a deeper understanding of the resistance for using SLT as a first-line therapy provides important information to help increase adoption.